UL Hospitals Group has this week commenced writing to patients in the community to advise them that they shared a ward or clinical area before their discharge with a patient who subsequently had a positive result for CPE, which is an antibiotic resistant organism. Antibiotic resistant organisms are often called superbugs. The word superbug is used to mean bacteria that are hard to kill with antibiotics. CPE is a relatively recent global health problem. A number of different kinds of CPE have been introduced into Ireland and have spread in the healthcare system in recent years.
As such, these patients are designated CPE Contacts. A patient who is a CPE contact is so defined because they have shared a ward or clinical area with someone who has been found to be carrying CPE. There is about a one in 20 chance that someone who is designated a contact will become a carrier of CPE. There is about a one in 400 chance that they might get a serious CPE infection at some time in the future. CPE infection can be serious but there are antibiotics that can be used to treat CPE infection.
In August 2018, the HSE announced that it was undertaking a national communications programme to write to patients who had been identified as being a CPE contact. This decision was based on recommendations from a National Expert Group published in July. The HSE asked every hospital to review their files and compile a list of patients. UL Hospitals Group has now completed this validation exercise and has commenced writing to patients this week.
Patients who are designated as CPE contacts are already informed while in hospital if they were still an inpatient when an exposure event was identified. Up until now, patients who had left hospital before they were identified as contacts were only informed on their return to that hospital if ever re-admitted. However, if they did not come back to hospital, they may not have been informed.
In the absence of defined best practice internationally, the National Expert Group has recently advised that these patient contacts be informed proactively, both retrospectively and on a continuing basis.
For most patients who carry CPE it never causes any illness, but lies harmlessly in the gut. Most people in Ireland who carry CPE have picked it up in hospital in Ireland. We believe, based on testing, that the number of people who carry CPE in Ireland is still fairly small (probably about 2,000). Last year (2017) 433 new people were found to be carrying CPE in Ireland. The HSE has committed resources and clinical support to help reduce the spread of CPE and to manage healthcare associated infections.
UL Hospitals Group has commenced sending letters to 2,160 patients advising them of their CPE contact status. This does not mean they have CPE. Their status as a contact means that they will be tested upon re-admission to a hospital. Comprehensive information about the CPE Contacts Communications Programme is available on the HSE website
A dedicated helpline is being provided to all CPE Contacts should they have any questions. Both the GPs and the consultants of each patient contact will also receive letters to ensure they are also informed about this contact.
Testing for CPE is not recommended for patients in the community as per national guidance. CPE contacts do not need any special treatment or medicine because of this exposure. It is important, as it is for everyone, that hands are washed regularly especially after visiting the toilet. All CPE contacts will be issued with a CPE Contact Card which should be brought into any hospital if attending for medical care.